Background: DICOM created a common software platform enabling communication between devices from different vendors. This allows the creation of a PACS (Picture Archiving and Communication System) - a hospital network of imaging modalities, graphics workstations, film printers, and archiving devices. The aim of this study was to show the practical aspects of using a heterogeneous PACS, composed of equipment from several vendors. Both advantages and problems in the cooperation of theoretically "DICOM compatible" devices are presented. Material/Methods: A heterogeneous PACS was gradually created in our department between 1998 and 2003, currently consisting o f a Siemens CT multi-row scanner, a GE MRI scanner, a GE rotational angiograph, Siemens, GE, Marconi, and eFilm Medical graphics workstations, and Agfa thermal printers. DICOM 3.0 was used as a common protocol and the 100 Mb Ethernet as the hardware solution. Connectivity and interoperability in such a system were tested. Results: Using the DICOM protocol, it was possible to transfer images from the modality of one vendor to the graphics workstation of another vendor and then use sophisticated software for image processing. It was also possible to use storage devices such as CD recorders for images from modalities without a built-in storage option. In spite o f theoretical DICOM compatibility, in some cases it was not possible to achieve correct communication in practice. Conclusions: DICOM enables the gradual creation of a PACS with devices from different vendors, thus reducing implementation costs. Using a PACS, many different imaging modalities may use the same graphic workstations and digital printers. Usually one could expect full compatibility o f all DICOM devices; however, in practice cooperation is sometimes limited or erroneous, reducing the benefits of the standard. Archiving data on CD-ROMs is a solution which greatly reduces the operational costs of a radiology department
